This is the third part of a monthlong series in honor of Women’s History Month.
In honor of Women’s History Month, we want to celebrate some of the outstanding women at Stanford Medicine Children’s Health who make such a difference for our patients – and the community at large. In this Q&A, each of these women share the story of how she came to her profession, how it’s changed, challenges she faced along the way and some of the issues she’s passionate about.
Hayley Gans, MD, is a member of the FDA’s Vaccine Advisory Committee reviewing COVID vaccines and a specialist in pediatric infectious diseases who studies the immune response to vaccines in children, including those who are immunocompromised. Kelly Mahaney, MD, is the interim division chief of pediatric neurosurgery and a pediatric neurosurgeon who treats children with spinal abnormalities, epilepsy, brain tumors and hydrocephalus, among other conditions. Irogue Igbinosa, MD, is a fellow in maternal and fetal medicine and recipient of Maternal Child Health Research Institute (MCHRI) grants for ongoing work on anemia in pregnancy, COVID-19, and health disparities in pregnancy.
How did you choose your field and what are some of the key events that helped shape your career and enable you to reach your position today?
Gans: I was attracted to pediatrics because I wanted to make a difference in children’s health, an impact that had the potential to help individuals be healthy for a lifetime. I am fascinated by the changes in health and therefore medical management that occurs over a child’s life as their body matures. The idea of advocating for the health of someone who doesn’t have their own voice at times is at the core of how I view my role. Doing my best for every child is important to me but I also know that this drive can help parents during the terrifying time when their child is ill, which is additionally meaningful.
From pediatrics, I then chose to subspecialize in pediatric infectious diseases. Infections span all of childhood, so I continue to care for children at all stages of their lives. Infectious diseases as a field is always emerging. New pathogens, such as SARS-CoV-2, become important, and organisms that are not harmful in some individuals are deadly in others whose immunity is lessened. This means that I am always learning and required to stay current to provide the most cutting-edge medicine. Infectious diseases also tend to be treatable and while children can be very ill, they more often than not fully recover. I feel blessed to be part of their recovery.
Mahaney: I was drawn to neurosurgery early on in medical school. I met a neurosurgeon at a surgery interest group luncheon hosted at my medical school and was completely captivated by the challenging operative cases he showed in his talk. He told me, “We need more women in neurosurgery,” and that was absolutely true then and still is true now. My decision to pursue neurosurgery was confirmed with every clinical rotation in medical school where I found myself longing for the operating room and the fascinating brain surgery cases. Although the patients we care for are often the sickest in the hospital, I felt that this was an opportunity for me to have an impact in people’s lives. We have the privilege of caring for patients at what is often the most vulnerable time of their lives – and in many cases have a chance to restore their health. During my rotation in pediatric neurosurgery, I saw how the impact we have on children is even greater – with their whole lives ahead of them. This has been the biggest motivation for me – to give children with neurosurgical conditions a chance for a brighter future.
Igbinosa: My interest in women’s health began as I watched my mother advocate for families as a licensed social worker and mother of five. Her heart for the community served as my blueprint for providing respectful care and elevating the missions of voices less heard.
I was first drawn to obstetrics when I witnessed a birth as a high school student rotating with a local midwife. I still recall the setting of the room, the family’s anticipation, and the midwife coaching me on how to place my hands on the baby’s rapidly approaching head! Yet, sometimes there are more challenging moments. The opportunity to work on the Centers for Disease Control and Prevention (CDC) Zika Pregnancy Task Force post-residency spurred my interest in maternal-fetal medicine (MFM) and providing care for families with high-risk conditions. I love that MFM is a unique field where we work collaboratively to care for mothers with chronic health concerns and provide prenatal genetic screening options, fetal ultrasound, and pre – and postnatal care.
What changes have you seen in your field over the years?
Gans: The biggest change inpediatric infectious diseases has been the growing number of individuals who have a suppressed immune system and thus are susceptible to infections. This includes the fields of oncology, organ transplantation, as well as individuals with diseases that require treatments to suppress their immune system. All these populations have expanded as these fields have advanced, and paramount to the care of these children is their increased susceptibility to infections. In addition, as the world becomes more accessible and travel is common, infections that used to be restricted to one geographic area are often seen globally and thus require infectious diseases physicians who understand these conditions.
However, the change that is the saddest for me, has been the decreasing number of people going into pediatric infectious diseases, largely due to the unequal pay. For a field that is important to most other areas in medicine, it will be a crisis when infectious disease physicians are not involved with the care of children suffering from infections.
Mahaney: When I began my neurosurgical training, I was the only woman in my department. Currently, I am fortunate to be a faculty member in a department with many other women faculty and residents. I remember hearing in a talk at a national meeting as a second-year resident that women needed first to attain even a minority representation in neurosurgery in order to have a voice in our field. At that point, women did not even represent minority in the field. Now, more women are choosing this profession and are unapologetic about living their lives as well. More women are choosing to start their families during neurosurgery training and are working toward more of a work-life balance. We are far from achieving this goal, but I am happy to see the needle moving in the right direction.
Igbinosa: From telehealth, alternative prenatal care models (centering), fetal interventions, landmark clinical trials, and evolving technology — the field of OBGYN/MFM continues to grow and expand. Notably, the impact of social determinants of health and structural inequities on adverse pregnancy outcomes has received national attention. Working to close the health disparities gap is an area of personal and professional interest in my career.
What advice do you have for women in your field who are at the early stage of their career?
Gans: My advice is inspired from what I wish I knew early in my career. Be visible and make sure others know what you are doing and thinking. Don’t let your self-doubt hold you back, seize opportunities. Be vulnerable and ask for help; it is not a weakness. Reach out to others even if this is not in your comfort zone as medicine is more collaborative than ever before. If you wish to have children, I recommend doing so early if feasible as you do not know how it will impact your career choices. Sponsor other women; always put someone forward for an award or opportunity. In my opinion, there is no balance to work and life, so embrace integration and make sure each day has both (sometimes more life and sometimes more work, but both), and when you are busy at work, make it up to yourself, your significant other, family, pets, etc. by being busy with life. Lastly, be present, don’t plan or review your to do list in your head when you are with others. These moments cannot be replaced or redone.
Mahaney: I would counsel women pursuing neurosurgery to go after their calling. If you feel called to this profession despite the long and arduous training, despite the mental and physical challenges of this profession – if you feel called to help the sickest of patients – then you know you are in the right field. Don’t put your life on hold. Neurosurgery is never going to make time for you to have a life – it is something you must make for yourself. It is never easy, but it is possible, to be a great neurosurgeon and also be a great friend, daughter, sister, mother, spouse. It is up to us to shape the future of neurosurgery and I hope many more women will choose this path and shape it with me!
Igbinosa: I would encourage everyone to find mentors! I am thankful to the many mentors who have selflessly guided me over the years. One of my favorite proverbs is “It takes a village to raise a child;” I encourage you to find your academic support system. In that same vein, find others you can reach out to and share the pearls you have picked up along the way. Maternal Fetal Medicine/Obstetrics and Gynecology is an extremely rewarding career – the opportunities to have a positive and lasting impact are endless!
